Nutrition Table of Contents

An Overall Heart Healthy Lifestyle ...... 3

Recommended Daily Intakes ...... 4

Good Fat – Bad Fat ...... 5

Healthy Eating Plate ...... 7

Mediterranean Pyramid ...... 8

Characteristics of the ...... 9

DASH Diet (especially for hypertension) ...... 12

Choose the Leanest Proteins ...... 13

Spreads ...... 14

Omega-3 Fatty Acids ...... 16

Fiber ...... 17

Sodium Smart ...... 18

Sodium-free Flavoring Tips ...... 19

Sugar Savvy ...... 20

Reading Food Labels ...... 21

Cooking Tips and Recipe Substitutions ...... 22

Dining Out ...... 23

2 An Overall Heart Healthy Lifestyle

1. Don’t smoke

2. Maintain a healthy weight*

3. Engage in regular physical activity

4. Eat a *

5. Manage blood pressure*

6. Take charge of cholesterol*

7. Keep blood sugar or glucose at healthy levels*

diet-related*

3 Recommended Daily Intakes

nUTriEnT rEcoMMEndEd 1,500 2,000 inTaKE caloriEs caloriEs

Total Fat 25% – 35% calories 41 - 58 grams 55 - 77 grams

saturated Fat < 7% calories < 11 grams < 15 grams

Trans Fat < 1% calories 0 – 1.5 grams 0 - 2 grams

Polyunsaturated Fat up to 10% calories < 16 grams < 22 grams

Monounsaturated Fat up to 20% calories > 33 grams < 44 grams

Fiber 25 – 35 grams (10 grams of soluble fiber)

sodium < 1,500 mg

added sugar 6 tsp for women (< 24 grams) 9 tsp for men (< 36 grams) alcohol 1 drink* for women (optional) 2 drinks for men

* 1 drink = 12 oz beer = 5 oz wine = 1 oz hard liquor Source: American Heart Association

4 Good Fat – Bad Fat

Why follow a cardiac diet?

Saturated and trans fat raise bad cholesterol levels in your blood. Blood cholesterol may build up and cause blockages in your blood vessels. This is why a diet low in saturated and trans fat is good for your heart.

Here’s your guide to limiting bad fats and Fat: it’s not all bad including good fats in your diet: Fats are essential to good health. They provide Limit Bad Fats —Both saturated and trans fats storage for extra calories, insulate and cushion raise your blood cholesterol levels more than organs, help build cell membranes, make anything else in your diet. hormones and aid in absorption and the transport of A, D, E and K. saturated fats can be avoided by limiting: What you may not know is this: not all fats n Butter, cheese, ice cream, whole and 2% milk. are created equal. n Red meat and poultry skin. saturated fats in food can be bad. n Palm and coconut oils. They can raise the level of “bad” cholesterol (LDL) n Margarine and shortening. in your blood. Cholesterol is a soft, fat-like, waxy substance found in the bloodstream and in all Trans fats, which are formed when liquid oils are your body's cells. Too much bad cholesterol in the solidified, can be avoided by limiting: blood is a major risk for coronary heart disease. n Hydrogenated vegetable oils, margarine and shortening.

Unsaturated fats in food can be good. n Deep-fried foods.

They can lower the “bad” cholesterol levels in n Store-bought cookies, cakes, and pastries. your blood and help build “good” cholesterol (HDL), which seems to protect against heart Include Good Fats , both monounsaturated and disease. Unsaturated fats are found in large polyunsaturated fats. amounts in plant foods and they are usually liquid at room temperature. Monounsaturated fats can be found in:

n Olive, canola and peanut oil.

n Pecans, hazelnuts, pistachios, peanuts and almonds.

changing the fat content of your to n Avocados. eliminate saturated sources and include unsaturated sources can usually lower Polyunsaturated fats can be found in: your bad (ldl) cholesterol and sometimes Vegetable oils, such as corn, sunflower seed, raise your good (Hdl) cholesterol. n safflower and soybean oil.

n Walnuts, pine nuts and seeds.

5 Good Fat – Bad Fat

a special type of polyunsaturated fat known as omega-3 fats can be found in:

n Fatty fish (such as salmon, mackerel, trout, tuna and sardines).

Diets including omega-3 fats have been shown to lower heart disease risk. Aim for 2 three-ounce servings of fatty fish per week .

Triglycerides What are triglycerides? Triglycerides are a form of fat found in the What steps are necessary to lower bloodstream that are composed of fatty acids triglyceride levels? and glycerol. They are completely different from cholesterol. When you eat a , your 1. lose weight if you are overweight. triglyceride level increases significantly, as it is Excess body weight can elevate triglyceride a measure of any fat you have eaten. High levels levels. Reduce portion sizes and increase of triglycerides combined with high cholesterol intake of fresh fruits and vegetables. levels can increase your risk of coronary artery disease and heart attacks. 2. Exercise regularly. Engaging in physical activity for at least 30 How are triglyceride levels measured? minutes most days of the week will raise HDL A simple blood test is used to measure your (good) cholesterol, help you to lose weight and triglyceride levels. It is very important that lower triglyceride levels. triglyceride readings be performed after a 12 to 14 hour fast. 3. limit sweets. Cakes, cookies, fruit juice, soda and other For adults, fasting triglyceride levels should be sweetened items can raise triglyceride levels. less than 150 mg /dl. If the levels are higher, this signifies that you may be consuming too 4. Eat less saturated fat. much sugary food, too many calories or fat, or Limit butter, red meat, regular cheese, whole milk excessive alcohol. Reduced physical activity, and 2% milk. Choose poultry, fish, skim prediabetes and uncontrolled diabetes also can or 1% milk and low-fat cheese. cause elevated triglycerides. 5. consume omega-3 fatty acids. Omega-3 fatty acids in doses of two to four grams per day can help to lower triglyceride levels. Good sources of omega-3 fatty acids include fatty fish, but these high doses generally require supplements. Be sure to consult your doctor first.

6. limit alcohol. Alcohol can stimulate the liver to produce triglycerides. Limit alcohol to one drink per day for women and two drinks per day for men.

6 Healthy Eating Plate

Healthy oils Water Use healthy oils (like Drink water, tea, or coffee olive and canola oil) (with little or no sugar). for cooking, on salad, Limit juice (1 small glass/day). and at the table. Limit Avoid sugary drinks. butter. Avoid trans fat.

Eat whole grains (like brown rice, whole- wheat bread, and whole-grain pasta). Limit refined Eat plenty of grains (like fruits of white rice and all colors. white bread).

Choose fish, The more veggies— poultry, beans, and the greater the and nuts; limit red variety—the better. meat, bacon, cold cuts, Fried potatoes and and other processed meats. french fries don’t count.

stay active! Source: www.hsps.harvard.edu/nutritionsource

7 Mediterranean Diet Pyramid A contemporary approach to delicious, healthy eating

8 Characteristics of the Mediterranean Diet

Traditional Mediterranean meals feature foods grown all around the Mediterranean Sea. Easily adaptable to today's kitchens and busy lives, they include:

1. Grains, vegetables, and fruits should be eaten at most meals, because they are important sources of vitamins, minerals, energy, antioxidants, and fiber. An eating pattern high in these foods promotes good health and weight control when consumed wisely.

Grains. The majority of grains should be whole grains, such as wheat, oats, rice, rye, barley, and corn. These grains are best consumed in whole, minimally-processed forms. Refining and processing can remove many valuable nutrients including vitamins, minerals, and fiber.

Vegetables. Vegetables are an important staple of eating patterns of peoples in all the countries bordering the Mediterranean Sea, providing valuable nutrients. These benefits are amplified because the vegetables are normally cooked or drizzled with olive oil. Raw vegetables are also a healthy vegetable option.

Fruits. Whole fresh fruit is ever-present in the Mediterranean. No-sugar-added fruit juices provide only some of the same nutrition benefits as whole fruit, and attention to portion control and total calories is wise. Fruit "drinks" do not have the benefits of fruit juice.

2. olives and olive oil are central to the Mediterranean diet. Olives are universally eaten whole, and widely used for cooking and flavoring in the countries that border the Mediterranean Sea. Olive oil is the principal source of dietary fat used for cooking, baking, and for dressing salads and vegetables. Extra virgin olive oil is highest in health-promoting fats, phytonutrients, and other important micronutrients.

3. nuts, beans, legumes and seeds are good sources of healthy fats, protein, and fiber. They add flavor and texture to Mediterranean dishes.

4. Herbs and spices add flavors and aromas to foods, reducing the need to add salt or fat when cooking. They are also rich in a broad range of health-promoting antioxidants, and are used liberally in Mediterranean . Herbs and spices also contribute to the national identities of the various Mediterranean cuisines.

9 Characteristics of the Mediterranean Diet

5. cheese and yogurt are eaten regularly in the traditional Mediterranean diet in moderate amounts. The calcium in cheese and yogurt is important for bone and heart health. Low fat and nonfat dairy products are suggested to reduce saturated fat intake.

6. Fish and shellfish are important sources of healthy protein for Mediterranean populations. Fish such as tuna, herring, sardines and salmon are rich in heart-healthy omega-3 fatty acids, and shellfish and crustaceans including mussels, clams and shrimp have similar benefits. Fish and shellfish are not typically battered and fried in Mediterranean countries.

7. Eggs are a good source of high-quality protein, and can be especially beneficial for individuals who do not eat meat. Eggs are regularly used in baking in Mediterranean countries.

8. Meats are eaten in small portions by Mediterranean peoples, who prefer lean cuts. Poultry is a good source of lean protein without the high levels of saturated fat found in some cuts of red meat. With ground meats, 93 percent lean/7 percent fat is a sound choice.

9. sweets are consumed in small portions in the Mediterranean. Fruits are ever-present on Mediterranean tables, and are a normal way to end a meal. Gelato and sorbet are consumed a few times a week, in small portions.

10. Wine is consumed regularly but moderately in the Mediterranean, unless discouraged by religious beliefs. “Moderately” means up to one five-ounce glass of wine per day for women and up to two five-ounce glasses for men. Individuals should only drink wine if they are medically able to do so, and should ask their doctors for more information.

11. Water is essential for life, and proper hydration during each day makes a positive contribution to health, well being and energy levels. Individual variations in body sizes, metabolic rates and activity levels mean that some people should drink more water every day than others.

10 Characteristics of the Mediterranean Diet

12. Portion size. Because foods in the bottom section of the pyramid may be eaten in larger amounts and more frequently, portion sizes and frequency of consumption decline in the pyramid’s upper sections.

13. Moderation is a wise approach. A balanced and healthy diet accommodates most foods and drinks, so long as moderation and wise choices are the key characteristics. For example, enjoying a small piece of birthday cake, savoring a few slices of grilled steak, or relaxing with family and friends with a glass or two of wine or beer are important aspects of being human. As always, moderation is key.

14. Healthy lifestyle habits. Daily physical activity is important for overall good health. This includes strenuous exercise like running and aerobics, as well as more leisurely activities such as walking and housework or yardwork, or taking the stairs instead of the elevator.

15. Meals in the company of others. The Mediterranean Diet is grounded on the principles of enjoyment and pleasure. Foods, drinks and meals are best eaten with others, when possible, and savored.

11 The DASH Diet

This eating plan is from the "Dietary Approaches to Stop Hypertension" (DASH) clinical study supported by the National Institutes of Health. The DASH combination diet lowered blood pressure.

Food daily sErVinGs sErVinG sizEs ExaMPlEs siGniFicancE GroUP and noTEs oF EacH 1,500 2,000 Food GroUP caloriEs caloriEs

1 slice bread whole wheat bread, English major sources 1/2 C dry cereal of energy Grains & grain 5-6 7-8 muffin, pita bread, bagel, 1/2 C cooked rice, and fiber products cereals, grits, oatmeal pasta, or cereal

1 C raw leafy vegetable tomatoes, potatoes, , rich sources of 3-4 4-5 1/2 C cooked vegetable peas, squash, , potassium, Vegetables 6 oz vegetable juice turnip greens, collards, magnesium kale, , artichokes, and fiber sweet potatoes, beans

6 oz fruit juice apricots, bananas, dates, important sources 3-4 4-5 1 medium fruit oranges, orange juice, of potassium, Fruits 1/4 C grapefruit, grapefruit juice, magnesium 1/2 C fresh, frozen, or mangoes, melons, peaches, and fiber canned fruit pineapples, prunes, raisins, strawberries, tangerines

8 oz milk skim or 1% milk, skim or major sources low fat or 1 C yogurt low fat buttermilk, nonfat of calcium and nonfat dairy 2-3 2-3 1.5 oz cheese or lowfat yogurt, part protein foods skim mozzarella cheese, nonfat cheese

3 oz cooked meats, select only lean; trim away rich sources of Meats, poultry, 2 or less 2 or less poultry, or fish visible fats; broil, roast, or protein and and fish boil, instead of frying; magnesium remove skin from poultry

1.5 oz or 1/3 C nuts almonds, filberts, mixed rich sources nuts, seeds, 3-4 per 4-5 per 1/2 oz or 2 Tbsp seeds nuts, peanuts, walnuts, of energy, and legumes week week 1/2 C cooked legumes sunflower seeds, kidney magnesium, beans, lentils potassium, protein and fiber

12 Choose the Leanest Proteins

Make most of your choices from above the bold line.

MEaT & PoUlTry caloriEs saTUraTEd ToTal sodiUM (4 oz. cooked, fat trimmed, no FaT ( g) FaT ( g) (mg ) skin unless otherwise noted) Tuna, water packed 132 0 1 383 Turkey breast 153 0 1 64 Ground turkey breast, white meat only 146 0 1 69 Crab Meat 114 0 1 377 Flounder 132 0 2 89 Veggie Burger (Soy protein) 110 0 2 382 Lobster 122 1 1 323 Shrimp 122 1 2 230

y Ham, Hatfield, extra lean, low salt (2 oz) 60 0 1 460 l i

a Chicken breast 186 1 4 83 d Salmon 165 1 7 50 Ground Turkey, 93% lean 160 2 8 75 Egg, 1 whole 75 2 5 63 Venison 107 2 4 129 Turkey bacon, 4 slices (1 oz) 68 2 5 360 Pork Tenderloin / Boneless Loin 191 2 5 77 Cabot 50% red fat cheddar cheese (1 oz) 70 3 5 70 Cheese (Mozzarella-part skim) (1 oz) 72 3 5 132 Ground beef, 93% lean 172 3 8 75 Turkey, dark meat 213 3 8 79 Veal chop, loin 200 3 8 109 Beef top round 226 4 9 60

K 202 9 E Beef flank 4 50 E Ground turkey meat 226 4 10 67 W / 236 4 11 96 x Chicken, dark meat 1 Crab cake, broiled 253 4 12 510 Filet Mignon 244 4 12 72 Lamb Chop, loin 295 5 8 38 Cheese (Mozz, Cheddar, American) (1 oz) 103 5 8 233 Ground Chicken meat 240 5 9 79 Bacon, 4 slices (1 oz) 145 5 12 404 Scrapple, 2 large slices (3 oz) 195 5 12 650

H Steak, T-bone 264 6 13 66 T

n Sausage, 2 links (2 oz) 200 6 17 798 o Ham, roasted 256 6 17 1066 M /

x Pork chop (loin) 296 6 18 86 1 Ground beef, 90% lean 292 7 18 70 Corned beef 266 7 20 1,184 Ground beef, <90% lean 310 8 21 77 Prime Rib 336 10 22 85 Spare ribs, pork 449 13 34 93 Source: Bowe’s and Church’s Food Values of Portions Commonly Used. L. B. Lippincott Company, 1998. Updated 2011 13 Spreads

Choose spreads that have ≤ 1.5 grams of saturated fat per tablespoon (bolded items).

TUbs and sqUEEzEs (1 Tbs.) caloriEs saTUraTEd sodiUM FaT ( g) (mg)

Promise activ light spread 45 0.5 85 Promise light buttery spread 45 1 85 olivio light spread 50 1 90 smart balance light Heart right 50 1 80 country crock light 50 1 90 country crock with calcium & d 45 1 100 i can’t believe it’s not butter light 40 1 80 Fleischmann’s original 60 1 35 Parkay Fresh & creamy 70 1.5 80 brummel & brown spread Made With yogurt 45 1.5 90 smart balance light omega 3 50 1.5 80 smart balance light with Extra Virgin olive oil 50 1.5 70 smart balance light with Flaxseed oil 50 1.5 90 Promise buttery spread 80 1.5 85 olivio original spread 80 1.5 95 I Can’t Believe It’s Not Butter Light with Olive Oil 60 2 90 Land O’ Lakes Fresh Buttery Taste Spread With Olive Oil 70 2 80 Land O’ Lakes Light Butter with Canola Oil 50 2 90 Land O’ Lakes Butter with Olive Oil 70 2 80 Smart Balance Light Butter and Canola Oil Blend 50 2 90 Smarter Balance With Extra Virgin Olive Oil 70 2 70 Smart Balance Low Sodium 60 2 30 Best Life with Extra Virgin Olive Oil 60 2 100 Country Crock Churn Style 50 2 100 I Can’t Believe It’s Not Butter Original 60 2 90 I Can’t Believe It’s Not Butter With Olive Oil 70 2 90 Country Crock Original 50 2 100 Smart Balance Original 90 2.5 90 Smart Balance Omega-3 80 2.5 80 Olivio Coconut Spread 65 3 90 Land O’ Lakes Margarine Tub 100 3 105 Land O’ Lakes Whipped Butter Unsalted 50 3.5 0 Land O’ Lakes Whipped Butter 50 3.5 50 Country Crock Spreadable Butter With Canola Oil 80 3.5 65 Olivio Spreadable Butter 90 3.5 70 Land O’ Lakes Butter With Canola Oil 100 4 85 Kellers Salted Whipped Butter 70 4.5 55 Breakstones Salted Whipped Butter 70 4.5 55

14 Spreads

cooKinG and baKinG sPrays caloriEs saTUraTEd sodiUM FaT ( g) (mg)

Olivio Buttery Spray (5 pumps) 0 0 15 I Can’t Believe It’s Not Butter Olive Oil Spray (5 pumps) 0 0 0 Pam Original Spray (1 sec) 0 0 0 Smart Balance Buttery Burst Spray (1 sec) 10 0 0 sTicKs (1 Tbs.) caloriEs saTUraTEd sodiUM FaT ( g) (mg) Imperial Vegetable Oil Blend Stick 70 2.5 105 Country Crock Spreadable Sticks 70 2.5 90 I Can’t Believe It’s Not Butter All-purpose 100 3.5 95 Kellers Salted Butter 100 7 90 Plugra Salted Butter 100 7 90 Breakstones Salted Butter 100 7 90 Land O’ Lakes Salted Butter 100 7 95

15 Omega -3 Fatty Acids

benefits source – primarily fatty fish

n Decrease risk of heart disease, heart attacks, and stroke.

n Protect against irregular heartbeats that can cause cardiac-related death.

n Reduce triglycerides.

n May help reduce blood pressure.

n Keep HDL (good) cholesterol high.

n Reduce inflammation.

n May reduce pain of rheumatoid arthritis.

n Associated with lower rates of depression. HoW MUcH do yoU nEEd?

Eat fatty fish 2 times per week (3 oz. cooked = 1 portion)

TyPE oF FisH sErVinG sizE ProVidEs 1.5 g oF oMEGa-3 FaTTy acids

Anchovies, Herring, Atlantic Mackerel, Alaskan Salmon 1 serving (3 oz) Albacore tuna, sablefish, sardines 1 ¼ servings (3.75 oz) Bluefin tuna, trout 1 ½ servings (4.5 oz) Halibut 2 servings (6 oz) Fresh water bass, oysters 2 ½ servings (7.5 oz) Sea bass 3 servings (9 oz) Shrimp, Pollock 3 ½ servings (10.5 oz)

16 Fiber

Dietary fiber is the naturally occurring material in food that is not digested by humans.

HoW MUcH do yoU nEEd?

25 – 35 grams daily (10 grams should be soluble fiber) Look for ≥ 3 grams of fiber/serving

Soluble fiber can be found in fruits (such as apples, oranges and grapefruit), vegetables, legumes (such as dry beans, lentils and peas), barley, and oats.

n May moderate blood sugar.

n May lower LDL “bad” cholesterol by 1% for every 1-2 grams consumed each day.

siMPlE Ways To add FibEr To yoUr diET insTEad oF sUbsTiTUTE White breads/regular pastas Whole wheat breads/pastas White rice Brown rice Mashed or fried potatoes Baked potato with skin Fruit juices or canned fruit Fresh or dried fruits Potato chips Popcorn Refined cereals Bran cereals/oatmeal White flour Whole-wheat flour Meat, fish or poultry Lentils/beans Aim for 5 Fruits and Vegetables Daily

17 Sodium Smart

Too much sodium can contribute to high blood pressure—a major risk factor for heart disease. rEcoMMEndaTion Sodium makes the body hold on to extra water. ≤ 1500 mg sodium/day This extra fluid may cause shortness of breath 1 tsp of salt = 2,300 mg of sodium and fluid buildup in the legs, ankles, stomach or lungs and make the heart work harder. Look for an entrée with <500mg sodium

low-sodium foods These foods are low in sodium (salt). Main dishes side dishes other n All fresh meat, poultry and fish n Low-sodium cheeses and n Unsalted crackers n Eggs cottage cheese n Regular margarine (limit 3-4 teaspoons) n All fresh, frozen, canned fruit n Bread and cereal n Low-sodium ketchup and juice n All fresh, frozen, canned no-salt n Cooking oil and spray n Rice, macaroni, spaghetti (plain, vegetables n Salt-free nuts prepared without salt) n Fresh white and sweet potatoes n Jell-O, ice cream, sherbert n Unsalted or low-sodium soups n Spices, herbs n Healthy Choice frozen dinners n Sugar, honey, jam, jelly

High sodium foods These are foods high in sodium (salt) and should be avoided or eaten less often. Meats other foods seasonings n Bacon n Commercially prepared pasta ( Ramen n Ketchup n Bologna and other cold cuts Noodles), rice and potato mixes n Chili sauce n Cheese n Convenience entrees n Meat tenderizers n Chipped beef n Salted pretzels, potato chips, popcorn, n Mustard n Corned beef crackers, nuts n Olives n Frankfurters: beef, meat, chicken or turkey n Sauerkraut n Pickles n Ham (pork or turkey) n Soups: canned, dry mixes or frozen n Soy sauce n Sausage n Chinese food made with monosodium n Vegetable salts: celery, garlic, n Canned, corned, salted, smoked meats and fish glutamate (MSG) onion, seasoned salt n Anchovies n Worcestershire sauce n Caviar n Soybean substitutes

sodium content of beverages you need to include the sodium in beverages you drink with your daily salt allowance. low: 0 – 20 mg Medium: less than 150 mg High: Greater than 300 mg n Water n Milk n Vegetable juices n Fruit juices n Lower-sodium vegetable juice n Regular broths n Coffee & tea and broths n Mixed alcohol drinks n Carbonated beverages n Beer & wine n No-added-salt vegetable juices and broths 18 Sodium-free Flavoring Tips

When cooking, the following items may be used for flavoring instead of salt or seasonings that contain sodium.

Remember: A little bit of spice goes a long way. Be careful not to over-season.

spice blend recipe (makes about 1/3 cup) n 5 tsp onion powder

n 2 ½ tsp garlic powder

n 2 ½ tsp paprika n 2 ½ tsp dry mustard

n 1 ½ tsp crushed thyme leaves

n ½ tsp white pepper

TyPE oF Food FlaVorinGs THaT WorK WEll WiTH TyPE oF Food

Beef Basil, bay leaf, caraway, curry, dill, dry mustard, garlic, grape jelly, green pepper, mace, marjo - ram, mushrooms (fresh), nutmeg, onion or onion powder, parsley, pepper, rosemary, sage Chicken Basil, cloves, cranberries, mace, mushrooms (fresh), nutmeg, oregano, paprika, parsley, pineapple, sage, saffron, savory, tarragon, turmeric, thyme,

Eggs Chervil, curry, dill, dry mustard, garlic or garlic powder, green pepper, jelly, mushrooms (fresh), nutmeg, onion powder, paprika, parsley, rosemary, tarragon, tomato

Fish Basil, bay leaf, chervil, curry, dill, dry mustard, green pepper, lemon juice, marjoram, mushrooms (fresh), paprika, pepper, tarragon, tomato, turmeric

Lamb Cloves, curry, dill, garlic or garlic powder, mace, mint, mint jelly, onion, oregano, parsley, pineapple, rosemary, tarragon, thyme

Pork Applesauce, basil, caraway, chives, cloves, garlic or garlic powder, onion or onion powder, rosemary, thyme

Veal Apricots, basil, bay leaf, currant jelly, curry, ginger, marjoram, mushrooms (fresh), oregano, paprika

Vegetables Basil, dill, garlic or garlic powder, ginger, lemon juice, mace, marjoram, nutmeg, onion or onion powder, tarragon, tomato, sugar or sugar substitute, salt-free salad dressing, vinegar Allspice, anise, cinnamon, cloves, ginger, mace, nutmeg, vanilla extract, other extracts Desserts Source: American Dietetic Association

19 Sugar Savvy

Limiting sugar intake may help control blood sugar, triglycerides, and body weight. Tips for reducing sugar: n Buy sugar-free or low-calorie beverages. added and natural sugars n Consider using artificial sweeteners (Splenda, Stevia, Sweet & Low, Equal, and other brands). Naturally occurring sugars are found naturally in foods such as fruits and milk. Added sugars n Buy fresh fruits or canned fruits in water or are sugars and syrups added to foods during natural juice and avoid fruit canned in syrup. 1 preparation or processing or at the table. n When baking cut the sugar in the recipe by ⁄3 and replace with unsweetened applesauce.

n Look for products with < 6 grams of sugar per serving, except yogurt, milk, and fruits, which should have < 15 grams of sugar per serving (since they have some natural sugar).

n Look for ingredients such as maltose, sucrose, high fructose corn syrup, molasses, cane sugar, raw sugar, syrup, honey and fruit juice concentrates to determine if a product has added sugar.

daily liMiT Men n 6 tsp (~24 grams) of added sugar for women

n 9 tsp (~36 grams) of added sugar for men NOTE: A 12 oz can of soda has 8 tsp 9 Women (~32 grams) of added sugar 6

20 Rea ding Food Labels

HOW TO READ A FOOD LABEL . Carefully reading food labels can help you make healthy, nutrient-rich food choices

Be sure to check the serving size and servings per container. Should be less than 30% of calories. Calories listed are per serving. % Daily Value is based on a 2,000 calorie diet.

Trans fat should be Limit these. See limited. Avoid foods bottom of label. with “partially Sodium <500mg hydrogenated oil” listed per entrée. in the ingredients.

Read ingredient list. Avoid foods with 3g or more indicates sugar as one of the a good source of first three ingredients. fiber. Aim for 25-35g per day.

Choose foods with high values of these Note that fat has key nutrients. (10% more than twice the or more). calories per gram as carbohydrate or protein.



Ex. 120(fat calories)/260(total calories) X 100 = 46% fat – this food is too G:\Common\Nutrition\Educational Materials\Foodhigh in label fat.

21 Cooking Tips and Recipe Substitutions

Ways to reduce fat when cooking HEarT HEalTHy cooKbooKs n Roast—with a rack so meat or poultry doesn’t sit in its own fat drippings. Baste with fat-free n diabetes & Heart Healthy Meals for Two liquids like wine, tomato juice or lemon juice. n aHa low-Fat, low-cholesterol, 4th edition n Bake—in covered cookware with a little aHa low-salt cookbook, 3rd edition extra liquid. n n www.smartbalance.com n Grill or Broil—on a rack so fat drips away from the food.

n Stir-fry—in a wok with peanut oil.

n Microwave—needs no extra fat!

n Steam—in a basket over simmering water.

n Sauté—in an open skillet over high heat. Use non-stick vegetable spray, a small amount of broth, wine or canola oil.

n Poach—by immersing chicken or fish in simmering liquid.

n Braise or Stew—with more liquid than baking, on top of the stove, or in the oven. Refrigerate the cooked dish and remove the chilled fat before reheating.

HEarT-HEalTHy rEciPE sUbsTiTUTions insTEad oF sUbsTiTUTE Butter Soft spread margarine Salt Fresh herbs and spices Whole milk Skim or 1% Whole egg Egg substitute or 2 egg whites Oil in baking Applesauce Sour cream Low-fat yogurt, cottage cheese or Greek yogurt Ground beef Lean ground turkey Cream cheese Low-fat ricotta cheese 1 Sugar ⁄3 less sugar, sugar substitutes, fruit puree, etc.

22 Dining Out

TyPE oF MEal insTEad oF Try

n Pancakes n Whole-grain waffle with fresh fruit n Fried eggs n Omelette with veggies breakfast n Bacon or sausage n Lean ham or Canadian bacon n Croissant, pastry, muffin n Whole-wheat bagel or toast with low-fat cream cheese

n Steamed dumplings n Egg rolls or fried wontons n Boiled, broiled, steamed or lightly n Fried entrees stir-fried entrees chinese n Dishes with cashews or peanuts n Dishes with lots of vegetables n Fried rice n Steamed rice n Edamame

n Cream soups n Broth-based soups n Buffalo wings n Peel-and-eat shrimp Family restaurants n Fried chicken sandwich n Grilled chicken sandwich n French fries n Baked potato n Creamy coleslaw n Non-fat yogurt n Hot fudge sundae

n Jumbo cheeseburger n Kids meal burger n Fried chicken or tacos n Grilled chicken or salad bar Fast Food n French fries n Baked potato n Potato chips n Fresh fruit n Milkshake n Diet soft drink

n French onion soup n Mixed green salad with vinaigrette French n Hollandaise, Mornay, Béarnaise sauce s n Wine-based sauces n Creamy “au gratin” potato dishes n Lightly sautéed, crisp vegetables n Chocolate mousse n Peaches in wine

n Fried calamari n Roasted peppers Cheese or meat-filled pastas or Minestrone soup italian n n casserole-type dishes n Marinara, white or red clam sauce n Pasta with butter or cream sauce n Piccata dishes n Any scallopine or parmigiana

n Flour tortillas n Corn tortillas n Nachos n Grilled shrimp Mexican n Refried beans n Spanish rice n Quesadillas n Chicken fajitas n Flautas and Chalupas n Soft Chicken Taco n Taco salad with hard shell n Black beans or pinto beans

n Fatty cuts of meat—rib eye, n Leaner cuts of meat—London broil, steakhouses porterhouse, T-bone, prime rib filet mignon, round or flank steak, n Caesar or marinated salad tenderloin n Fried vegetables n Greens salad

Source: American Heart Association 23 Christiana Care is a private not-for-profit regional health care system and relies in part on the generosity of individuals, foundations and corporations to fulfill its mission. To learn more about how you can support our mission, please visit christianacare.org/donors.

www.christianacare.org/heart 16HRTC60